Pseudofolliculitis of the Beard Follow-up
- Author: Thomas G Greidanus, MD; Chief Editor: Dirk M Elston, MD more...
Further Outpatient Care
Outpatient evaluation and patient education is effective. With proper techniques, transfollicular and extrafollicular penetration can be minimized.
Hair-releasing procedures and shaving should be performed after a shower to hydrate and soften both the skin and the hair. Subsequent shaving results in a duller, rounded tip to the hair, which is less likely to reenter the skin.
Wash the beard with a face cloth, a wet sponge, or a soft-bristled toothbrush with a mild soap for several minutes using a circular motion. This technique helps to dislodge stubborn tips.
Using needles or toothpicks to dislodge stubborn tips is controversial. It usually is not recommended because overly aggressive digging with sharp objects can cause further damage to the skin.
Patients with pseudofolliculitis barbae may use razors if single-edged, foil-guarded, safety razors are used. Double- or triple-bladed razors shave too closely and should not be used. Commercially available foil-guarded razors have about 30% of the blade covered by foil, which prevents the blade from shaving the hair too closely.
Electric razors have acceptable results if used properly. The recommended technique with a 3-headed rotary electric razor is to keep the heads slightly off the surface of the skin and to shave in a slow, circular motion. Do not press the electric razor close to the skin or pull the skin taut because this results in too close of a shave. Some electric razors have "dial in" settings for the closeness of the shave. These may be effective if kept off of the closest settings.
Electric clippers are effective for resistant cases of pseudofolliculitis barbae. With clippers, 1- to 2-mm stubble can be left on the face. The tendency to shave too closely is reduced with this method, making it more effective. The appearance of stubble may be cosmetically unacceptable for some patients.
Although usually not regarded as a serious medical problem, pseudofolliculitis barbae may cause cosmetic disfigurement. The papules may lead to scarring, postinflammatory hyperpigmentation, secondary infection, and keloid formation.
Although usually not regarded as a serious medical problem, pseudofolliculitis barbae can cause cosmetic disfigurement. The papules can lead to scarring, postinflammatory hyperpigmentation, secondary infection, and keloid formation. No cure exists, but effective treatment is available. If the patient is able to grow a beard, the problem usually disappears (except for any residual scarring).
Instruct the patient to stop shaving for 3-4 weeks. This gives adequate time for the hair follicles to grow to a length where ingrown hairs will spring free.
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